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The injury: it begins

When I decided to write about my experience with post concussion syndrome and recovery, I was quickly overwhelmed by the topic. How do I start? The topic is enormous and the symptoms I have can be overwhelming at times. I realized that, unlike in college, there is no “due date” or grades on this blog. I can write bit by bit; depending on how I feel. I’ll talk about what’s happening now, what it was like earlier in the process, and about the brain and brain injury in time. In this entry, I’ll talk about how I was injured and what it was like the first couple of weeks after the injury.

On April 25, 2011, I was returning from providing clinic hours in a small town in Oregon. The weather when I left was overcast, with some showers, but the road conditions were clear. My route took me over part of the Blue Mountains. A winter storm struck. When I attempted to slow my vehicle, I lost control. Witnesses stated I slid from the left lane, through the right, hit the shoulder and rolled down an embankment, striking a pine tree. My only memory of the event was the feeling of “oh shit” and knowing I was losing control of the car. My next clear memory is walking down the interstate, talking to the witnesses who had stopped to help. I somehow called 911 and my supervisor without any memory of doing so.

I was taken by ambulance to a hospital, treated, and released. The experience is vague in my memory. I had a ferocious headache, felt nauseous, and was in pain from other injuries. The hospital treated and released me. A CT (“cat”) scan showed no breaks or bleeds in my head. I later learned that head injuries often do not show on either CT scans or MRIs, regardless of severity. A clear CT meant I wasn’t bleeding seriously in my head and had no fractures. A coworker picked me up and later commented that my conversation was tangential; flowing from topic to topic with little or no association.

The first challenge I faced was understanding that I was injured. I did not recognize the symptoms I was experiencing the first two weeks. I spent most of that time either at home, sleeping much of the time, or at follow-up medical appointments. I remember trying to communicate about an EKG with a doctor who was covering for my primary care physician. I could not find the words to express what I was experiencing and I barely recognized that something wasn’t “right” with me. She sent me to the ER, with concerns my EKG was unusual perhaps my heart had been injured. The irregular EKG was a normal deviation for me: I run marathons and it changes what my heart rhythm looks like. I couldn’t explain it. Nor could I get the second, different ER to understand that something was not right. I tried to explain about feeling “disconnected,” sick, “unreal,” having trouble concentrating, reading, etc. The doctor stated it was due to the medication for pain and muscle spasm. I had been on higher doses of both medications after an accident in the past without these side effects and I couldn’t express that to the doctor either. I was released from the hospital again and returned home.

Two weeks later, I briefly went into my work. A social work colleague noticed my eyes looked strange, and I was anxious, my speech was slow, and I was just “off.” Now, the employee health provider gets involved. One pupil was larger than the other and slower to respond, I was dizzy, nauseous, and on my way to the hospital again.

One of the challenges often faced by head injury patients is recognizing the symptoms she is experiencing and recognizing how they are impacting her. I felt like I was “normal”- just with a headache, nausea, and dizziness.

I have written about several symptoms I was having. Many of them I didn’t recognize until someone who knew me pointed them out and got involved. These symptoms are ones my friends and coworkers noted: slowing in speech and thought, difficulty concentrating, becoming overwhelmed and not being able to function in environments with a lot of sensory input, anxiety, concrete thinking, inability to problem solve.

Research has shown that head injury patients do better when they have a good support system. I have an excellent one. My supervisor, Theresa, my coworkers (especially Peggy and Dave), and Carol, the employee health provider. Carol took an active role in helping me get the tests, evaluations, and care I need. At the time, I could barely function. My family does not live near me. Yet, they offer support as they can. Without support from my friends and family, I wouldn’t be recovering as well as I am.